Indeed, during a gynecological examination, particular attention must be paid to the condition of the vaginal walls.
In practice, before inserting the speculum, the appearance of the vulva is carefully examined by spreading the labia and the Batholin glands are checked by gently pressing them with a gloved hand.
It is also at this time that we will be very careful to free the pubic hairs so as not to pinch them or pull them at the risk of causing pain for the patient.
Then we introduce the speculum with closed and vertical blades by rotating so that we arrive with horizontal blades.
At this time we will move aside to check that we are in the axis of the cervix to see its condition and take a smear or biopsy sample if necessary.
Then, when removing the instrument, we hold the blades slightly apart (having removed the blockage by the screw) and when removing it we examine the vaginal walls.
This step must be carried out with dexterity so as not to pinch the tissues studied.
If in doubt, the inside of the vagina can be dabbed with a compress soaked in acetic acid to ensure there is no risk of condyloma.
Personally, I am not a fan of transparent plastic speculums, I prefer metal instruments (Collin or Cusco) which are easier to insert without pain.